Individual
DR. TERESA MARIE KERGE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
2549 COWAN BLVD, FREDERICKSBURG, VA 22401-8440
(540) 368-3970
(540) 368-3973
Mailing address
3310 FALL HILL AVE, FREDERICKSBURG, VA 22401-3000
(540) 373-4602
(540) 373-5461
Taxonomy
Speciality
Code
Description
License number
State
208VP0014X
Interventional Pain Medicine Physician
Primary
0101259196
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0101259196
MEDICAL LICENSE
VA
01
—
1457308611
MEDICARE GROUP NPI
—
01
—
1851617120
NPI
—
01
—
C09813
MEDICARE GROUP PTAN
—
Enumeration date
04/12/2010
Last updated
03/07/2023
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